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USMLE Step 2 - Top 5% > ENT > Flashcards

ENT Flashcards

1
Q

Managment overview of oral leukoplakia

A

Biopsy it, reduce the risk factors, and monitor. Consider surgery

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2
Q

What is sialadenosis.

A

Benign enlargement of the parotid. Painless enlargement, due to alcohol, malnutrtiion, bulimia

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3
Q

Thyroglossal duct cyst Mx

A

Check to see if thyroid gland ok (associated with ectopic thyroid). Then do Sx (remove cyst, tract and part of hyoid)

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4
Q

Patient had thyroidectomy for CA. TG starts to increase a few months after.. Dx?

A

CA returning

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5
Q

Which bacteria can cause this paediatric neck mass

Necrotic LNs, voilacious skin

A

Mycobacterium avium lymphadenitis

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6
Q

Dx this

Lateral neck mass, gets bigger on valsalva. Patient is a trumpet player

A

Laryngeocele

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7
Q

Rhinitis medicamentosa

A

When someone takes nasal decongestant for a long time, the vessels get damaged, releasing edema and causing more nasal decongestion. Turbinates will be beefy red

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8
Q

Whistling on insp is a sign of

A

Nasal perf. Look out for nasal surgery or cocaine use

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9
Q

Mx of TMJ disorders

A

Soft diet and warm compress, then can try night guard if bruxism. Do NSAID if bad or initial did work. Muscle relaxant if muscle spasms,

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10
Q

Why can laryngeal or oral squamous cell carcinoma cause otalgia

A

Referred otalgia, since the CNX and CNIX innervation of larynx and tongue areas converge to the same areas as the ear sensory innervation

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11
Q

Invx and mx overview of choanal atresia

A

If suspect try and pass catheter down nasal cavity. If doesn’t pass, then confirm Dx with CT or endoscopy. Tx by keeping an oral airway until Sx

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12
Q

Epiglottis Abx to give empirically

A

Best to give Ceftriaxone (cover HiB and Strep) and Vanco (cover staphylococcus). Airway should be maintained prior

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13
Q

Invx and mx for mastoiditis

A

Clinical Dx, but can do imaging if unclear or suspect neuro complication. Give Abx and drain

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14
Q

Difference in location of issue between expiratory, inspiratory and biphasic stridor.

A

Insp is supraglottic obs, biphasic is subglottic and exp is tracheo (malacia )

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15
Q

Mx for peritonisllar abcess

A

Needle drainage then Abx

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16
Q

Dx

Patient has very similar symptoms to epiglottis. Is a young adult and uvula is deviated to one side

A

This is peritonsilar abscess

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17
Q

Difference in symptoms between viral and bacterial rhinosinusitis. And how to manage each

A

Viral; no or short lived fever, mild symptoms, resolved in less than 10 days. Bacterial; fever for at least 3 days, symptoms for more than 10 days, and worse signs. Supportive for the former and Abx for thr latter

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18
Q

Difference in presentation between acute OM and OM with effusion

A

AOM has active inflam, so will have bulging TM, fever etc.

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19
Q

Managment of O.E.

A

remove debris, Abx (cover pseudomonas and staph) commonly quinolone, with or without GCs

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20
Q

Tx for hairy leukoplakia

A

Just restore the immunity of the patient

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21
Q

Mx of a torus mandibularis or palatirus

A

If mass becomes symptomatic or compromises the eating, breathing of the patients. Also if it prevents the fitting of dentures.

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22
Q

Acute Otitis media vs otitis media with effusion signs and symptoms

A

AOM will have fever, pain, bulging tympanic membrane that is red and hardly transparent. Whereas OM and effusion is not inflammatory, so no fever, mild pressure, and can see the effusion fluid, but normal a tympanic membrane.

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23
Q

OM and effusion Mx (consider if last more than 3 mo)

A

Observe. If more than 3 months, it is chronic, and should be indicated for a Tymoanostomy

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24
Q

First line for necrotising otitis external

A

IV ciprofloxacin

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25
Q

What is paracusis of willisii

A

In otosclerosis, the patient can often hear better with background noise. Contrasted to presbycusis

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26
Q

What is oxymetazoline

A

Main nasal decong

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27
Q

Mx of ruptured tympanic membrane

A

Reassure and observe, only tympanoplasty if fails to heale

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28
Q

How can we reduce the risk of jaw osteonecrosis (say if patient on BPS)

A

Do dental consultation (do any dental Sx prior to BPS, since it’s a huge compound risk factor). Good oral hygiene and anti bac rinse.

29
Q

Questions that have patient with ulcerated enlarged tonsil,…. Always consider what

A

Consider SqCC. Old smoker, or young slag (HPV).

30
Q

Patient presents with vertigo and hearing loss on one side. Valsalva worsens vertigo. When dr claps loudly, the patient gets nystagmus (Tullio phenomena)

A

Perilymphatic fistula

31
Q

Nasal polyp fist line imaging

A

Coronal sinus CT

32
Q

Nasal polyp first invx? Then the rest of the invx

A

Nasal speculum. Consider laryngoscope. Coronal Sinus CT Best imaging. Biopsy if atypical

33
Q

Nasal polyp Mx

A

Oral CS. Recall discussion with Billy.

34
Q

If epistaxis does not improve with initial Conservative management. What do we do

A

Rhinoscopy to see where the anterior or posterior circulation

35
Q

If anterior epistaxis. What’s the management approach

A

Conservative therapy first. If doesn’t work can do cauterisation (with silver or electrical). If unilateral we can do packing. A second line would be to do bilateral packing.

If none of this works consider posterior

36
Q

Posterior epistaxis management

A

ENT consultation. Do balloon catheter or Foley catheter

37
Q

Pain with movement of the tragus or Pinner. Is this more a otitis media or a otitis external

A

OE

38
Q

If the otitis externa has granulation tissue, what does this mean

A

Usually means it’s malignant

39
Q

What cranial nerve can be involved in malignant otitis external

A

Facial nerve

40
Q

Puretone audiometry results for conductive disorders

A

Increased audiometry threshold in air conduction only

41
Q

Pure tone audiometry in sensory hearing loss problems

A

Increase audiometry threshold in both and bone conduction

42
Q

Oral submucosal fibrosis main cause

A

Araca nuts (betel, paan)

43
Q

other than biopsy oropharyngeal CA. What else do we need to do

A

Laryngo broncho esophago scopy to check for 1° CA. Then of course usuals to check for mets

44
Q

Main Tx for Sialithiasis

A

Conservative. Sialogogues, warm compress, fluids, massage, NSAID.

45
Q

Main appearance different between ranula and mucocele

A

Ranula is blueish

46
Q

Usually we do self resolution of ranula and mucocele. But what to do if recurs/symptomatic

A

Sx. Not drain

47
Q

Pleomorphic adenoma Tx

A

Need to remove. Even though it’s usually benign

48
Q

A positive RINNE means what

A

Better conduction on air then bone

49
Q

Main way to tell between labyrinthitis and cute vestibular Neuritis

A

Labyrinthitis will have vertigo and hearing loss

Oh vestibular and righteous will not have hearing loss

Both of them are a cute and monophasic

50
Q

Compare labyrinthitis with Meniere

A

Is labyrinthitis is a cute and monophasic, Merania is intermittent and has a bit of tinnitus

51
Q

Necrotising otitis externa management

A

Give IV antibiotics. Anything that covers pseudomonas

52
Q

Management of otitis media with effusion

A

Just observe and follow up. If more than three months consider t tube

53
Q

Name me two causes of sialadenosis

A

Bulimia, booze

54
Q

Before removing a thyroglossal duct cyst, what do I have to do

A

Just make sure that normal thyroid is okay, because it is associated with ectopic thyroid

55
Q

If thyroglobulin increases after a thyroidectomy, For thyroid cancer,what does this mean

A

Recurrence of cancer

56
Q

Left or right neck mass, that is painful. History of recent URI. Mass is anterior to the SCM

A

Branchial cleft cyst

57
Q

Contrast the turbinate in retinitis medicamentosa, versus allergic rhinitis

A

Beefy read in the prior, more pale in the latter

58
Q

Contrast sialolithiasis management with or without infection

A

Give water, moist heat, milk the gland, NAISAID.

If infected give antibiotics, and refer to ENT to remove the stone

59
Q

Why give Foxy And Vanco for epiglottitis prophylaxis

A

Because staphylococcus is increasing in this disease, because HIB is Rajitha vaccine

60
Q

Somebody with history of otitis media, and now has tenderness behind ear and ear displaced forward. What is this

A

Mastoiditis. Clinical diagnosis. If there’s neurological issues do a CT

61
Q

Location wise of an inspirational Striedel versus biphasic strider

A

Supraglottic, then subglottic respectively

62
Q

Patient has sinusitis, but has yellow green nasal discharge. Had for three days, but doesn’t have a fever. Is this viral or bacterial

A

Viral.

63
Q

NRDS patient, still needs 02 after one month and has high blood pressure. These are two signs pointing to what

A

Bronchopulmonary dysplasia

64
Q

What is the often con commitment pathology with laryngomalacia

A

Gerd

65
Q

Main treatment of laryngomalacia

A

Should self resolve. If very bad do surgery

66
Q

 If somebody has a pain, but yet the whole year exam as normal. Which two places are you worried about referral

A

TMJ, or some kind of tongue/laryngeal carcinoma. So if you don’t think it’s TMJ do flexible laryngoscope

67
Q

Chronic large ulcerated right tonsil in younger patient with multiple sexual partners. Around 40 years old

A

Probably squeamish cell carcinoma from HPV

68
Q

Best medication for otitis externa

A

Topical quinolone.

USMLE Step 2 - Top 5% (34 decks)

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